Nishi A, Ito Y, Amamoto Y, Aida K, Kato H
Department of Paediatrics and Child Health, Kurume University School of Medicine, Japan.
Pediatr Nephrol. 1995 Oct;9(5):562-5. doi: 10.1007/BF00860932.
This study was conducted to evaluate longitudinal changes in the peritoneal equilibration test (PET) in children treated with continuous peritoneal dialysis (CPD). The effects of prolonged CPD and episodes of peritonitis on the PET were examined. PET was repeated up to five times in 12 paediatric patients who were subdivided into groups with and without peritonitis. In the peritonitis group (n = 6), the dialysate/plasma (D/P) creatinine ratio at a 4-h dwell time decreased progressively with time on CPD in five of six patients. In a comparison of the initial and final PETs performed at a mean interval of 22.8 +/- 11.6 months, the D/P creatinine ratio in the final PET was significantly lower than in the initial PET (P < 0.01). In contrast, in the non-peritonitis group (n = 6), the D/P creatinine ratio in the final PET was unchanged for 28.2 +/- 12.3 months from the initial PET. The D/Do glucose ratio at a 4-h dwell time was unchanged over time in each group. Thus, repeated PET measurements revealed that membrane permeability for creatinine was not affected by prolonged CPD itself, but decreased with time after episodes of peritonitis. Although the protocol for PET is not standardised in children, PET was useful for determining the sequential changes in peritoneal function in such patients on CPD.
本研究旨在评估接受持续性腹膜透析(CPD)治疗的儿童腹膜平衡试验(PET)的纵向变化。研究了长期CPD和腹膜炎发作对PET的影响。对12例儿科患者重复进行PET检查达5次,这些患者被分为有腹膜炎组和无腹膜炎组。在腹膜炎组(n = 6)中,6例患者中有5例在4小时留腹时间的透析液/血浆(D/P)肌酐比值随CPD治疗时间的延长而逐渐降低。在平均间隔22.8±11.6个月进行的初始PET和最终PET比较中,最终PET中的D/P肌酐比值显著低于初始PET(P < 0.01)。相比之下,在无腹膜炎组(n = 6)中,最终PET中的D/P肌酐比值在距初始PET 28.2±12.3个月的时间内未发生变化。每组4小时留腹时间的D/Do葡萄糖比值随时间未发生变化。因此,重复进行PET测量显示,肌酐的膜通透性不受长期CPD本身的影响,但在腹膜炎发作后随时间降低。尽管儿童PET的方案尚未标准化,但PET对于确定此类接受CPD治疗患者的腹膜功能的连续变化很有用。